Hale Goksever Celik, MD

Dr. Goksever Celik is an obstetrician and gynecologist, graduated from the medical school of the Hacettepe University in Ankara, and trained through Obstetrics and Gynecology fellowship at Dokuz Eylul University in Izmir. She has been a postdoctoral research fellow at Molecular Biology and Genetics at Istanbul University. She has been participating in several research especially interested in the association between endometriosis surgery and ovarian reserve and the genetic basis of endometriosis.

How does pregnancy affect endometriosis?

Endometriosis is the localization of endometrial stromal and glandular cells outside the uterine cavity. Pregnancy is offered as a treatment option for patients with endometriosis because it causes atrophy of endometrial cells similar to progesterone treatment. Progesterone predominance during pregnancy, as observed before menarche or after menopause, generally leads to regression of endometriosis-associated symptoms due to the development of amenorrhea. Although there is not much evidence about the fate of endometriotic lesions and related symptoms after pregnancy, pregnancy is recommended…

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Patients preferences for the treatment of endometriosis-associated pain

Endometriosis is defined as the location of endometrial stroma and glands outside the uterine cavity. The most common presenting complaints are mainly dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility, most of which relate to the menstrual period. Those women affected by endometriosis demand therapy for the symptoms of endometriosis, notably dysmenorrhea and non-menstrual pelvic pain. Despite extensive research, the optimal management of endometriosis still remains unclear. Non-steroidal anti-inflammatory drugs, narcotics, hormonal contraceptives, progestin therapy, gonadotropin-releasing hormone (GnRH) analogs (eg, leuprolide,…

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Melatonin receptors and their role in endometrial cell proliferation

Women with endometriosis demand therapy for the most common symptoms, which are pelvic pain and infertility. Despite extensive research, the exact pathophysiological mechanism and the optimal management of endometriosis still remains unclear. Management of endometriosis should aim to relieve pain, ameliorate infertility and improve quality of life. Current medical and surgical treatment options have several limitations including the side effects, costs, the risk of recurrence, and effects on conception capability. The benefit of melatonin, which is a hormone produced by…

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The accuracy of "lower endoscopic ultrasound" for the preoperative diagnosis of rectosigmoid endometriosis

Endometriosis affects reproductive-aged women most frequently with a prevalence of 5% to 15%. If the endometriotic lesions involve the bowel especially sigmoid colon and rectum, this subtype of endometriosis is named as "bowel" or "rectosigmoid" endometriosis. Rectosigmoid endometriosis is encountered in 3.8% to 37% of all women with endometriosis. Dyschezia, constipation, diarrhea, abdominal bloating, and cyclical rectal bleeding are the most common findings in women with rectosigmoid endometriosis. The differential diagnosis of rectosigmoid endometriosis from irritable bowel syndrome with similar symptoms…

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Infertility in women with endometriosis

Endometriosis is an estrogen-dependent gynecological disease mostly encountered in reproductive-aged women. The most common presenting complaints are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Despite extensive research, the etiopathogenic mechanism underlying the two has not been fully elucidated. Although human experiments are limited for ethical reasons, animal experiments have shown that there is a causal relationship between endometriosis and infertility. This association between endometriosis and infertility seem to be multifactorial, including mechanical, molecular, genetics, and environmental aspects. Pelvic cavity factors,…

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Health care resource utilization and cost in women with endometriosis

Endometriosis is a chronic inflammatory disease affecting 6-10% of reproductive-aged women. The clinical picture of the disease range from asymptomatic findings to dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Endometriosis has also complex etiopathogenetic background. This broad clinical spectrum, the lack of understanding of the etiopathogenesis delay, make the diagnosis and treatment of the disease difficult. Despite extensive research, the optimal management of endometriosis still remains unclear. The decision for treatment should be patient-centered considering patient’s clinical presentation, age, the…

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The predictors for the coexistence of uterine leiomyomas and endometriosis

Uterine leiomyomas are the most common gynecological benign tumors affecting 20-25% of reproductive-aged women. Abnormal bleeding, pelvic pain, pelvic pressure, and infertility are major symptoms of these tumors. Endometriosis is another gynecological disease encountered in 10-15% of reproductive-aged women. The most common symptoms are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Both diseases share some common features such as estrogen dependence, similar potential symptoms, and genetic predisposition. Ultrasound and/or magnetic resonance imaging can be used for the accurate differential diagnosis.…

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The coelomic metaplasia hypothesis of endometriosis in MRKH cases

Endometriosis is defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity and its incidence is approximately 10% in the general female population. Although the pathophysiological mechanism is not clearly understood, the implantation theory by Sampson is the most accepted hypothesis. According to the Sampson theory, endometriotic lesions develop from the endometrial cells spreading into the peritoneal cavity through Fallopian tubes during menstruation. However, retrograde menstruation occurs in most women, but the incidence of endometriosis is…

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Non‑invasive biomarkers for endometriosis diagnosis

Endometriosis is a disease of women in reproductive age and its incidence varies between 5-10%. Since the diagnosis is based on the histological confirmation, there is an average of 7 to 11 years of delays in the diagnosis. Promising non-invasive biomarkers are needed for early diagnosis and treatment of endometriosis. However, there is no biomarker with high sensitivity and specificity that has been validated in the diagnosis of endometriosis to take place in clinical use. Irungu et al, a group of…

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The genetic predisposition to endometriosis

Endometriosis is an estrogen-dependent gynecological disease mostly encountered in reproductive-aged women. Although endometrium is a non-malignant disease, its symptoms can range from mild to severe due to the inflammation that ectopic endometrial tissue forms around itself. The exact etiopathogenetic mechanism has not been understood, although several mechanisms support the presence of a genetic predisposition. A group of scientists from Italy and Greece, led by Dr. Angioni, recently published a review entitled “Genetics of endometriosis: a comprehensive review” in the journal…

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The postoperative functional outcomes of deep infiltrating endometriosis

Rectosigmoid endometriosis is defined as the infiltration of the bowel wall with the endometrial-like glands and stroma, reaching at least the muscular layer. The most commonly involved sites are the rectum and sigmoid colon. For the management of deep infiltrating endometriosis, conservative rectal surgery by shaving or disc excision, or radical rectal surgery by segmental resection should be performed. However, there is no study identifying the predictive factors of postoperative functional outcomes in these patients. Roman et al, a group…

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The coexistence deep infiltrating endometriosis and fibromyalgia

Endometriosis is defined as the localization of endometrial glandular and stromal cells outside the uterine cavity. The main symptoms of endometriosis which are dysmenorrhea, dyspareunia, and chronic pelvic pain impair the quality of life of these women. This disease may be accompanied by some other chronic diseases such as fibromyalgia. Coloma et al, a group of scientists from Spain, published a study titled as “Prevalence of fibromyalgia among women with deep infiltrating endometriosis” in the journal named as International Journal…

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Preoperative factors to predict unresponsiveness in women undergoing endometriosis surgery

Endometriosis is defined as the localization of endometrial glandular and stromal cells outside the uterine cavity. Despite extensive research, the optimal management of endometriosis still remains unclear. Several treatment options include analgesic medication, hormonal treatments, and surgical intervention. There is still a risk of relapse despite extensive surgery for endometriosis. Ghai et al, a group of scientists from the United Kingdom, published a study titled as “Identifying pre-operative Factors Associated with Non-Responders in Women Undergoing Comprehensive Surgical Treatment for Endometriosis”…

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The appearance of postoperative endometriosis by imaging methods

Endometriosis is a chronic gynecological disease mostly encountered in reproductive-aged women. Endometriosis can occur in three different entities: peritoneal, ovarian and deep endometriosis. Golden standard diagnosis is made by histopathological examination of surgical material after laparoscopic surgery in women with suspicious symptoms. Although there are several medical treatment options for endometriosis, surgery remains the most important and necessary part of the treatment algorithm. Postoperative follow-up plays a vital role to determine the development of postoperative complications and/or recurrence. Guerra et…

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The miscarriage rate in women with endometriosis undergoing IVF fresh cycles

Endometriosis is a chronic estrogen-dependent disease diagnosed in 25-40% of women with infertility. There are several mechanisms explaining the negative impacts of endometriosis on fertility through the entire reproductive process such as sperm-oocyte interaction, ovarian reserve, and implantation. Endometriosis is also associated with poor obstetric outcomes including preterm birth, intrauterine growth restriction, and babies’ small for gestational age. Miscarriage is the most common obstetric complication in the first trimester. In the literature, there are controversial studies about the association between…

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Which comes first in endometriosis management: In vitro fertilization or surgery?

Endometriosis is defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity. The prevalence is found to be 7%–10%, but among infertile women, it increases up to 50%. Early diagnosis and personalized management are important to improve fertility outcomes. Although there are several treatment strategies, there is no clear consensus about the definitive approach. Surgery or IVF can be suggested as the first approach in the management of endometriosis. Lessey et al, a group of scientists…

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The association between the development of endometriosis and dietary habits

Endometriosis is a chronic disease defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity. The prevalence is found to be approximately 10% in the general population. Endometriosis is associated with infertility, pelvic pain, and increased risks for ovarian and other cancers. Delay in clinical diagnosis has been reported due to the asymptomatic presentation of the disease at the early stages. Although there are several treatment strategies, there is no clear consensus about the definitive approach…

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Endometriosis and female pelvic pain in all aspects

Endometriosis is defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity. The prevalence of the disease ranges between 6-10% in reproductive-aged women. However, endometriosis is more frequently encountered in women with chronic pelvic pain and infertility. The symptoms including dysmenorrhea, dyspareunia, chronic pelvic pain can be variable in patients with endometriosis. Because symptoms have a significant impact on their quality of life, early diagnosis and personalized management will be beneficial. Kim et al, a group…

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Surgical techniques for rectosigmoid endometriosis, and functional outcomes

Rectosigmoid endometriosis is defined as the infiltration of bowel wall with the endometrial-like glands and stroma, reaching at least the muscular layer. Rectosigmoid endometriosis is encountered in approximately 8-12% of patients with a diagnosis of endometriosis. The most commonly involved sites are the rectum and sigmoid colon. There is still no clear consensus about the management of rectosigmoid endometriosis, although there are different surgical methods including rectal shaving, discoid resection, and segmental rectosigmoid resection. Mabrouk et al, a group of…

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Endometriosis-associated pain control by contraceptive implant or intrauterine system

Endometriosis is defined as the localization of endometrial glandular and stromal cells outside the uterine cavity. The most common symptoms are dysmenorrhea, dyspareunia, and chronic pelvic pain, all of which affect the quality of women’s lives. Several studies investigating the efficacy of levonorgestrel-releasing intrauterine system on endometriosis-associated pelvic pain have been performed. However, the etonogestrel-releasing contraceptive implant as an alternative for this purpose has not been adequately evaluated. Carvalho et al.,  from Brazil,  along with a group of scientists lead by Dr.…

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